The Impressive Yet Underestimated Dog Spay

Not long ago, a family member from out of town brought in her dog so I’d take a quick look at a lump. Because it’d be at least a month before she’d be back to her hometown, I agreed to remove the small mass ASAP. Once underway, however, she called to ask if I could spay the dog, too, “as long as you’re already there."

Now, strictly speaking, I wasn’t even in the neighborhood. The lump was in the skin over the right side of her belly. Meanwhile, a “spay” is a sterilization procedure that typically denotes the removal of the uterus and ovaries — all of which live inside the belly. Yet, like most veterinarians, I’m well-accustomed to the common misconception that anything roughly around the abdomen might as well be within the abdomen.

As widespread as this anatomical muddling might be, more common is the erroneous conviction her request implied: That a spay is a simple procedure… one that’s easily tacked on to most any other with a minimum of stress, discomfort, time, ability or expense.

An Invasive Abdominal Procedure

Now, from the veterinarian’s point of view, little could be further from the truth. The everyday ovariohysterectomy is a procedure that’s both hard to master and easy to underestimate. In fact, there’s no routine procedure I can think of that compares to the spay for its high degree of difficulty and unpredictability.

Which is probably why most veterinarians I know (especially the newly minted ones who are still on the steep part of its learning curve) tend to count the humble spay among the most stressful procedures we perform — at least when it comes to doing them in dogs.

Patient Size, Age, Heat Cycle and Fat

The high variability within the canine species can make for an especially challenging surgical experience (two to 200 pounds is an extreme range for surgical patients) — more so when you consider the variations that accompany any given canine patient’s life stage and reproductive cycle.

What’s worse is that we often have no idea what we’re getting into until we get in there! So what seems like a “simple” spay worthy of a 20-minute stint (as most young dog spays are for me) might just end up as an hourlong slog in a sea of friable fat and leaky vessels. Or worse… in an overnight stay at the ER for close observation in case additional internal bleeding transpires.

Speaking of fat… When you add in the soaring rates of canine obesity and the increased incidence of later-in-life sterilization (where I live, anyway), it’s a wonder I haven’t had more ER-worthy spay complications in my career (I’ve had two in 18 years).

Which is probably why I included the fat-dog version of this procedure and one of its permutations, the pyometra surgery, on a recent list of “dreaded jobs” in veterinary medicine.

A Surgery That Deserves Respect

Yet for all its potential trickiness and its formidable learning curve, the spay remains the one procedure pet owners most often toss off in conversation… as if it involves little more than a “tying of tubes.” It’s also the one most likely to earn us complaints whenever we try to increase its price tag.

Indeed, so underrated is the spay that, on the menu of veterinary items, even castration seems to garner more respect.

What’s up with that?

This misconception has perhaps less to do with the fact that people don’t know their anatomy than with the widespread notion that a spay is an undemanding procedure every dog should undergo and, as such, that it must be easy to do if it’s so commonly performed.

Which, in a sense, argues that we veterinarians — the procedure’s champions — have been largely responsible for any lack of respect afforded it. I mean, why else would we call it a “spay” instead of an "ovariohysterectomy" if we didn’t want people to think it was something straightforward every female dog should have?

While it’s true that the widespread campaign to see all our dogs sterilized might’ve had an inadvertently "dumbing down" effect on our cultural conception of the spay, I’ll argue we’re now all grown-up enough to see the procedure for what it is: a highly effective tool for treating and preventing female reproductive diseases and a means of achieving population control, to boot… yet a procedure which is, nonetheless, not without its risks.

As such, I’ll argue that the spay should be considered more respectfully in our culture. It should be treated neither like a surgical “add-on” nor a “price-cut” procedure. Operations this substantial and valuable don’t deserve to be emasculated for the purposes of mass consumption — even if what’s at stake is something as significant as pet overpopulation.